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Parliament Week: Refugee Rehabilitation and Mental Health

Written by Anna Yoganathan, Volunteer at ACAA

The conference held by the ACAA during Parliament Week covered a broad range of topics with the first panel focusing on the current situation in Afghanistan and the second on the experiences of refugees resettling in the UK. Focusing in on the second panel, I would like to draw attention to the discussion raised by Dr Ayesha Ahmad about refugee mental health. She provided a much-needed insight into an aspect of refugee rehabilitation often ignored, meaning that prior research into this area has been minimal. Dr Ahmad is a lecturer in Global Health at St George’s University of London who has been studying the long-term effects of the Afghan war on the mental health of its survivors.

In general, coverage of the effects of conflict on mental health take a back seat in journalistic and academic perspectives, despite its severity and prevalence. Dr Ahmad stated that this is in part due to our ‘western orientated biometrical paradigms of trauma’ which fail to accommodate for the experience of civilians in war-torn states. As such, both the evidence base and academic literature in this area is lacking, leaving it to academics such as herself to attempt to fill these gaps so that more substantial findings can be drawn.

The fact that lived experiences of war are underrepresented in the mental health field means that their effects on long-term mental health are often inadequately dealt with. Furthermore, the reliance on personal testimony in the granting of asylum seeker status brings to the forefront the more immediate problem of the effect of trauma on memory. In a society in which the Home Office reduces asylum claimants to their experiences as victims, inconsistencies are met with suspicion and little acknowledgement is paid to the damaging effects war has on long term mental health. Asylum seekers are expected to suppress their trauma and continue life without properly addressing it, as Dr Ahmad says ‘There is no time to bleed. Life does not stop; life must be lived. And the suffering is buried deeper and deeper into a grave that is never left, but carried within’.

This reduction of their identity to their status as a refugee or asylum seeker is often mirrored in larger society, affected by negative portrayal in the media which marginalises their plight and creates a constant stigma they must work to overcome. On top of this they have to cope with cultural adjustments, language barriers, loss of previous socio-economic status (many refugees are over qualified for the jobs that they end up taking up), break with their imagined future and fear that their status will be revoked and they will be forced to leave.

According to the Mental Health Foundation asylum seekers are five times more likely to have mental health needs than the general population, yet data shows that they are less likely to receive support for these needs. Dr Ahmad also stressed the need for increased awareness of cultural sensitivity in medical practice. Shared cultural identity with a medical practitioner can be a major advantage in effective treatment, given that many trauma survivors would rather discuss delicate psychological matters with someone of the same religion or gender. Furthermore, the concept of disclosing such sensitive issues with a health care professional can be alien to those coming from a culture where mental health is extremely stigmatised. Psychiatry UK reports that somatisation (the manifestation of psychological distress by the presentation of bodily symptoms) among refugees is often as high as physical pain and more acceptable than psychological pain.

Continued research into this field will hopefully pave the way for better understanding and treatment of victims of war-caused trauma, empowering them in their effort to restore some degree of normality to their lives and acknowledging that the damaging impact of war does not stop at the border.

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